Endoscopic retrograde cholangiopancreatography (ERCP) is a complex and challenging procedure with impressive diagnostic and therapeutic potential that comes along with a relatively low but real risk of adverse events. One of the more common adverse events is bleeding, typically from endoscopic sphincterotomy. Herein, we describe approaches for the practicing endoscopist to identify, prevent, and manage ERCP-related bleeding. Clinical judgment and knowledge of patient-related risk factors are important for preprocedure planning. Various techniques can be employed to mitigate bleeding risk during and after the procedure. Finally, we offer practical advice on managing these difficult cases when ERCP-related bleeding occurs.
KeywordsEndoscopic sphincterotomy Post-sphincterotomy bleed Gastrointestinal bleeding ERCP-related adverse event Endoscopic hemostasis
SW is a consultant for Boston Scientific and Medtronic.
This study was supported by a grant from the University of Colorado, Department of Medicine, Outstanding Early Scholars Program (SW) and the NIH Gastrointestinal Diseases Training Grant T32 DK007038 (JK).
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